Efforts to improve health and address inequalities in Scotland have been “filling the gaps” for decades, Scotland’s Chief Medical Officer Dr Harry Burns has said, as he calls for a Scottish Population Health Programme.
The conventional ways of health improvement that have been tried in Scotland need “re-thinking”, Burns told delegates at the annual NHS Scotland conference this week.
“It is not just about handing out a million pounds for a project that gets evaluated after three years and gets stopped because it hasn’t quite worked the way we thought it would work. There has to be a different way of doing things.”
Burns advocated switching to a health assets model, which sees individuals recruited as co-producers of stronger social networks in communities and empowers them to improve their health and wellbeing, rather than “preaching” to people about where they are going wrong.
He explained: “The health asset is whatever there is out there that enhances the ability of individuals, communities and populations to maintain their health and sustain their sense of wellbeing. It protects those individuals from whatever life throws at them so perhaps we should be thinking more about the assets in the community than the deficits that are out there, because the deficits approach focuses on problems and inefficiencies. It focuses on the damaging behaviours and it requires us to go out and preach. It requires us to go out and tell people that what they are doing is going to kill them and if you live in a sink estate, you don’t need to hear that.”
What we are and have been doing for decades is “filling the gaps and disempowering individuals”, said Burns, which has led individuals to become “passively receivers of services that others decide to give them.”
He advocated adopting a similar approach to health improvement as has been adopted for patient safety.
“In addition to the Scottish patient safety programme, why don’t we have a Scottish population health programme and adopt the same kind of methods, because if we can measure it we can change it,” he said.
Burns said he would be “very happy” to work with individuals who want to develop such a model that builds on the ministerial taskforce on health inequalities report, ‘Equally Well’.